Anaesthetic consultation late in pregnancy

[AliBaby]

Did anyone Else HAVE to have one?

I was told I had to book in for one at 38 weeks because I have a high BMI. The thing is, I am only 3kg heavier now as I was at the same time with my first pregnancy,and I didn't have one then. Same hospital.

They said something about there are higher risks as i am overweight, etc and they have to check my back when I asked for more info about the reason for the consult.

I plan on a natural birth and had a natural birth with DD with no complications. My medical history is great. No GD, no excessive weight gain (I have only gained 3.5kg), no family history of any health problems, this pregnancy has been fine, my blood pressure has been consistently 110/70 (the same as what it was with DD's pregnancy).

So I am just concerned and quite upset/offended that they feel i need the consult. I even had a cry about it tonight. Yes I am overweight but I trust my body and feel confident that I can birth this baby. I now all of a sudden feel like they think i can't.

Anyone else go through this and can shed some light on what exactly this is all about and so important that I must have it?

[TeniBear]

Yeah, I had to have one! Waste of time IMO, even though I did end up having an epidural. They ended up checking all that stuff when prepping me for it anyway. Oh, except for him checking my throat to make sure they'd be able to incubate me if needed, because I said I sometimes get little growths near my tonsils (trying to remember the proper name for them...) :-/

[little_O]

Yes, but I didn't end up doing it because the anesthetist ended up refusing to deal with me at my chosen hospital because I didn't want to accept certain treatment. My right to birth choice didn't suit theirs apparently...

Changed hospital and ob and never had to see one (as planned).

It was the original hospitals policy though and it wasnt dependent on bmi...you sure it's not the same at your hospital?

Apparently because it was a private hospital with limited resources they made it compulsory so that they were prepared and "could accommodate"....

[peanutter]

I had one both times around I think. It was more about making sure that I knew what the options were, and what I was and wasn't happy too do, so that they weren't trying to explain pros and cons if I was in the swing of things, and high as a kite on gas.

Informed consent/refusal and all that.

Maybe their policy has just changed over the past few years, and it's got nothing to do with your weight?

I know that several things changed in the 20 months between my two

[blessedatlast]

I agree maybe policies have changed etc.. It is a good idea, as Peanutter said, for proper informed consent. They are boring and annoying though..

[Bloom]

I had to have one with my first (even though I planned to have a natural birth) and the Dr was confused as to why I was there as although I was overweight/obese, I look smaller than I weigh. The numbers on the scale meant I had to have the appointment to see that they could get an epidural in ok. It was all fine and I didn't end up having an epidural for the first or two subsequent births. Interestingly I was much heavier for my 3rd, and I didn't have to have an appointment for her...

I agree it must just be a hospital policy. Just try to brush it off, go along, get seen and try to put it out of your mind.

The Dr told me you had to be massively obese for it to be a problem.

[2CheekyMonkeys]

What sort of BMI requires that?

[Bloom]

The consultation requires a BMI of 30+ at my local hospital but that was back in 2009

[AliBaby]

My BMI is 30 s I am right on the borderline. I have always been heavier thAn what I look and am quite well proportioned (the weight is spread evenly around my body but interestingly enough, I don't carry it around my middle apart from now being pregnant).

The midwife made it pretty clearly was because of my BMI that I have to have the consult. I even saw an OB at the beginning of pregnancy, my second appointment, as the same midwife said it was because of my BMI. When the OB saw me and went through my medical history and current health he said he didn't need to see me anymore and i could go through the midwives clinic. It just sucks being on the cut off line and because of a matter of 2-3kg that I am made to feel like this. Really hope I don't see the same midwife I saw yesterday for the rest of my pregnancy as she really made me feel crap about myself. Not the first time she has either.

Thanks for all of your replies. It sounds like it is going to be a waste of time. Will let you know how I go in a couple of weeks.

[beansbeans!]

I have never had to have one. But if it doesnt sit right with you, regardless of whether its hospital policy, then refuse the appt, and you have every right to do that if thats what you want to do. They cannot refuse you treatment if it isnt done, they cannot bully you into having the appt either.
And do not feel bad about your weight, or your bmi. And dont worry about that right now. You can carry this bub to term, and you can deliver this bub. xo

[The[cookie]Doctor]

Alibaby don't stress too much, even though you are borderline I guess they still have to account for you understanding of safety.
I had one with my last baby and it was basically to be told that because BMI is higher that surgery is more dangerous, and higher chance of death if any complications due to intubation being more difficult on overweight patients. It is scary but I think supposed to be about educating you to try not to have an epidural as that can slow the natural progression of labour.
They were also supposed to locate the place on my spine - i think to save time in labour as large tertiary hospital, but it never happened.
You already know that you want a natural epidural free labour so im sure it will be short and sweet for you!

[AliBaby]

I have never had to have one. But if it doesnt sit right with you, regardless of whether its hospital policy, then refuse the appt, and you have every right to do that if thats what you want to do. They cannot refuse you treatment if it isnt done, they cannot bully you into having the appt either.
And do not feel bad about your weight, or your bmi. And dont worry about that right now. You can carry this bub to term, and you can deliver this bub. xo

Thanks so much Beans. I have tried to be so healthy this pregnancy. I just want positivity around me from my care providers that I can do it. Just like you said. Thanks again Hun x

[Novella]

As a nurse I know there are increased risks to anaesthics if you are overweight/obese. I think the reasoning behind the hospitals policy is as much to do with emergency anaesthic rather than how hard it would be to get an epidural in for pain management. In an emergency situation where mother or baby's life is at risk the delay trying to get a spinal block/epidural in to someone who has difficult anatomy can be life threatening, however there are risks with general anaesthetic too so a full assessment prior to birth is done to make a decision prior to a possible emergency what the best route of anaesthetic administration is in your case.

You have every right to refuse an anaesthetic assessment but make sure you discuss the reasons behing the assessment so you can make an informed decsion. Discuss it at your next appointment

[RainbowRiver]

I was told last two pregnancies I was to have a consult... Never happened. At 11 weeks this time I was told I'd see one at 38 weeks, I said no I don't want to and I won't, midwife looked over past babies and noted I never had any problems pre birth and births were straight forward, and agreed that there's no point.